Pioneering the future: incorporating lifestyle medicine tools in osteopathic medical education

Biomechanical model

The biomechanical model focuses on the musculoskeletal system and its role in maintaining overall health and well-being. It recognizes that structural imbalances, such as misalignments or restrictions in the musculoskeletal system, can impact the body’s ability to function optimally. Physicians can utilize osteopathic manipulative treatment (OMT) to restore alignment and function. OMT is a powerful tool in providing immediate relief of pain and in assisting the body to realign itself, whereas lifestyle approaches can assist in longer-term relief of pain and decreased chance of re-injury.

By integrating lifestyle tools, physicians can provide guidance to decrease overall inflammation within the musculoskeletal system and assist patients in minimizing tightness in the system via physical activity and stress reduction techniques. At a more granular level, research shows that anti-inflammatory dietary patterns are significantly associated with reduced markers of inflammation [5], 6]. More importantly, dietary patterns that reduce inflammation are associated with reduced risk of musculoskeletal pain [7], 8].

Respiratory–circulatory model

The respiratory–circulatory model emphasizes the importance of the respiratory and cardiovascular systems in maintaining health and vitality. It recognizes that efficient oxygenation and circulation are essential for delivering nutrients and removing waste products from tissues. OMT is integral to improving respiratory mechanics to optimize oxygenation and lymph movement.

Complementing with a lifestyle approach can provide patients with mechanisms to optimize endothelial function, including vasodilation and the production of factors that prevent hypercoagulability. LM’s focus on changes that reduce inflammation can decrease excessive mucus production in the respiratory system. Together, the approaches can optimize oxygenation and circulation.

From a nutritional perspective, diets rich in soluble fiber and phytosterols reduce cholesterol levels significantly [9], 10]. Also, nitrate-rich whole foods such as dark leafy greens and beets improve oxygenation by increasing plasma nitric oxide levels [11], 12]. Providing these resources for patients in addition to OMT can further support the body to achieve homeostasis.

Neurological model

The neurological model acknowledges the central and peripheral nervous systems’ role in regulating the body’s physiological processes and responding to internal and external stimuli. It recognizes that neurological imbalances can manifest as pain, dysfunction, or altered sensations. Osteopathic physicians skillfully utilize OMT to reduce neural tension and enhance neurological resilience. OMT can also treat nerve dysfunction by reducing irritation.

Infusing a lifestyle approach offers clinicians the skills to provide specific breathing and/or mindfulness techniques and to apply specific suggestions founded in any of the six pillars to regulate mood further. Restful and restorative sleep is one of the pillars of LM and is central to daily cycle homeostasis. Disruption of the normal diurnal sleep cycle can trigger a stress response and increase sympathetic nervous system activity with many downstream adverse effects.

Social connectedness also plays an important role within this model. Studies indicate that assisting patients to build strong social relationships can improve the risk of premature mortality more than other factors such as maintaining a normal body mass index (BMI), abstaining from alcohol, or obtaining the pneumococcal vaccine [13].

Bioenergetic model

The bioenergetic model focuses on the body’s inherent capacity for self-regulation and healing. It recognizes that the body’s energy systems, including cellular metabolism and bioelectric fields, play a vital role in maintaining health and responding to stressors. OMT and LM tools can optimize inherent self-regulation. For example, by releasing tensions in fascia or by releasing restriction, OMT can improve the flow of energy through the body. In promoting better nutrition, physical activity, and restorative sleep, lifestyle approaches assist in optimizing metabolic function and decrease inflammatory burdens that may be barriers to high energy levels [14], 15].

With LM approaches, physicians may guide patients nutritionally to improve their microbiome. Such shifts decrease overall inflammation in the system, modulate mood, and improve mitochondrial function [16], 17].

Biopsychosocial-spiritual model

The biopsychosocial-spiritual model takes a comprehensive approach to health and well-being, considering the interconnectedness of biological, psychological, social, and spiritual factors. It recognizes that these dimensions influence each other and collectively contribute to an individual’s health outcomes. Utilizing patient-centered care, touch, and compassionate communication, osteopathic providers enhance healing.

LM approaches mental and spiritual well-being by addressing topics such as social connectedness and sense of purpose routinely with patients. Data on the importance of social connection, especially in relation to other life factors, is well supported [13], 18]. Additionally, working with patients to recognize a sense of purpose improves health outcomes and longevity [19]. However, for some patients, a physical approach to mental health may be most important. In this realm, practitioners can work on increasing activity to improve neuroplasticity, increase mood, and modulate cortisol responses [20], 21].

Summary of the five models of care

In summary, utilizing the most recent science around lifestyle management in conjunction with the five models of care will promote behaviors that support musculoskeletal health, cardiovascular and respiratory function, neurological resilience, energy dynamics, and holistic well-being. LM has packaged an approach to health that allows osteopathic physicians to efficiently apply it within the five models of care in addressing the root causes of illness and promoting optimal health and vitality.